Dr. Lucas Thor Henningsen, MD
Family Medicine in Two Harbors, MN. Individual provider (NPI-1).
NPI number1164045647
StatusActive
Last updated in NPPESNov 13, 2024
Details
- NPI
- 1164045647
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lucas Thor Henningsen
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 19, 2020
- Certification date
- Nov 13, 2024
- Last updated
- Nov 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 70026 | MN | Yes |
Practice location
325 11th AveTwo Harbors, MN 55616-1300
Phone 218-249-5555
Mailing address
325 11th AveTwo Harbors, MN 55616-1300
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